What’s New: Metabolomic Prediction of Diabetes and Cardiovascular Risk

Type 2 diabetes mellitus (T2DM), currently an epidemic, is expected to disproportionately affect developing countries in the coming decades. Thus, primary prevention of T2DM is a global imperative. However, a thorough understanding of its pathophysiology is a prerequisite to the development of comprehensive strategies for diabetes prevention. One emerging area in the field of metabolism is the discovery of the role of small molecules and metabolites in the regulation of carbohydrate and lipid metabolism, and their association with metabolic disorders. The small molecules and metabolites under evaluation include branched chain amino acids (BCAAs, isoleucine, leucine, and valine), aromatic amino acids (AAAs, phenylalanine, tyrosine), methionine, glutamine, acylcarnitines, urea cycle intermediates, purine degradation products, bile acids, ketone bodies and lipid moieties. The circulating levels of these metabolites are typically measured using liquid chromatography/mass spectrometry, and analysis of their expression profiles in relation to integrated metabolic pathophysiology constitutes the tenets of the emerging science of metabolomics.